I thank members for the invitation to meet the Joint Committee on Health to discuss the issues facing acute hospitals this winter and the HSE winter plan. I am joined by my colleagues, Ms Anne O'Connor, chief operations officer, Dr. Colm Henry, chief clinical officer, Mr. Liam Woods, national director, acute operations, and Ms Yvonne O'Neill, national director, community operations.
As members will be aware from the daily headline figures, we are now firmly in the midst of a fourth surge in Covid-19 infections. The entire health system, both acute hospitals and community, are now under serious pressure. Last Monday week, I briefed the Cabinet sub-committee on Covid-19 on the seriousness of the situation. The Government responded with a number of public health measures. It has also been necessary for the HSE to take immediate measures in response to hospital and ICU pressures, including the short-term prioritisation of unscheduled care, and increasing our surge capacity through providing additional beds, particularly in ICU. I know that the resurgence of the virus, and the response now required, will place even more pressure on staff. I assure the committee that we will do everything we can to support our staff during this difficult period.
The winter season in any year presents additional challenges to all health systems around the world, with presentation related to the combination of seasonal viruses, weather-related trauma and illness, longer periods spent indoors with lower levels of ventilation and seasonal social activity. Pressures associated with winter of 2021-22 are further compounded by the massive increase in Covid-19 infections we are currently experiencing, and the resulting presentations in emergency departments and onward into wards and, critically, intensive care units. Emergency departments continue to operate distinct pathways of care for Covid and non-Covid patients, and this places a huge demand on staffing and space available.
In line with the principles of Sláintecare, the HSE winter preparedness plan identifies a comprehensive set of actions and initiatives aimed at mitigating the pressures on services. As part of this integrated plan, the HSE will focus on avoidance of hospital admittance unless absolutely necessary, patient flow through hospitals, and safe and timely departure of patients from hospital. The plan provides for the appropriate, safe and timely care for patients by ensuring, insofar as possible, the right levels of capacity and resources are in place to meet the expected growth in activity levels. This includes the use of private hospitals to increase capacity in the short term and to support the continuance of urgent unscheduled care while the system is in surge. There will be an enhanced focus on patient experience times, and performance against these targets will be monitored by integrated oversight and reporting teams.
A total of €77 million has been provided by the Government to support these actions and initiatives. This investment builds on previous winter plans and the National Service Plan 2021 in developing and promoting the home first approach, which was supported through additional investment in home support hours in 2021. General practice is also key to the success of this approach.
The HSE continues to work closely with general practice through the chief clinical officer and GP forum, and in collaboration with the Irish Medical Association and the Irish College of General Practitioners, ICGP, in responding to the Covid-19 pandemic, as well as providing core primary healthcare services.
The Covid-19 supports to general practice for assessment and referral for testing remain in place. In terms of our strategic priorities, an important first step in ensuring the sustainability of general practice for the future has been the implementation of the GP agreement of 2019, involving an investment of €210 million over the period from 2019 to 2022, including the roll-out of a new structured programme, chronic disease management, for medical card and GP visit card holders over 18 years which will apply to 431,000 patients when fully implemented in 2023. This will also see the appointment of a GP lead in each of our 96 community healthcare networks to ensure for the first time a structured process of engagement with general practice at local level and to facilitate integration and co-ordination with our acute hospital services.
A further strategic priority for the HSE has been the expansion of the GP workforce. To this end, an important milestone was achieved this year with the successful transfer of the GP training programme to the ICGP. In addition, GP training places have been increased by 27 in 2021, with a further 24 in 2022, bringing the total to 259 next year, with a targeted increase to 350 training places by 2026.
A consequence of the significant rise in hospital attendances through emergency departments has been the necessity to relieve the overall pressure on hospitals by evaluating planned procedures and cancelling less urgent appointments for both day cases and inpatients. The number of cancellations and non-booking of planned surgery has been growing due to the growing incidence of Covid-19 in hospitals.
The Department of Health published a waiting list action plan in October 2021. This plan was developed in collaboration with the HSE and the National Treatment Purchase Fund and it focuses on delivering additional procedures through public and private hospitals by the end of 2021 with a view to reducing waiting lists. The plan sets out targets in terms of numbers of patients waiting at the end of the year. Those targets are 69,822 for inpatient and day cases, 653,524 for outpatients and 33,128 for gastrointestinal scopes. Since the inception of the plan, the number of outpatients waiting has reduced by 12,450. The number waiting for GI scopes has reduced by 1,819. However, progress on the inpatient and day case waiting lists has been significantly affected by the cancellation of electives due to Covid-19 and emergency department pressures, which has resulted in a smaller reduction. A significant focus is being placed on using private hospital capacity to deal with these waiting lists. However, public hospitals are also relying on access to private hospitals to support emergency workload pressures.
The HSE also welcomes the additional funding of €200 million announced by the Government for 2022 to support access to care which will be focused on delivering additional capacity to impact waiting lists. This funding will be targeted at working through these lists as quickly as possible by making the best use of our own capacity, supplemented by making arrangements for a substantial number of procedures to be carried out through the contract arrangements with private hospitals.